Abstract

Honey is recognized traditionally for its medicinal properties and also appreciated as a topical healing agent for infected and noninfected wounds. This study evaluates impact of honey-based occlusive dressing on nonhealing (nonresponding to conventional antibiotics) traumatic lower limb wounds (n = 34) through clinicopathological and immunohistochemical (e.g., expression of p63, E-cadherin, and Collagen I and III) evaluations to enrich the scientific validation. Clinical findings noted the nonadherence of honey dressing with remarkable chemical debridement and healing progression within 11-15 days of postintervention. Histopathologically, in comparison to preintervention biopsies, the postintervention tissues of wound peripheries demonstrated gradual normalization of epithelial and connective tissue features with significant changes in p63(+) epithelial cell population, reappearance of membranous E-cadherin (P < .0001), and optimum deposition of collagen I and III (P < .0001). Thus, the present study for the first time reports the impact of honey on vital protein expressions in epithelial and connective tissues during repair of nonhealing lower limb wounds.

Schematic representation of the adopted method to generate intensity data for E-cadherin (a) and Collagens I and III (b). In both assessments, basement membrane (BM) was used as reference point. For E-cadherin (a), the P1, P2, and P3 along the white line represented three equidistant points in the epithelial expression path, while expression of collagen molecules in dermis (b) were assessed along 200 μm (the white vertical line) below basement membrane at three equidistant points that is, P1, P2, P3.

Immunohistochemical photomicrographs (40x oil, a-p) of skin biopsies (normal and leg wound periphery): (a)–(d) depicted expression of p63 in intact (a), before (b), after 15th days (c), and 22nd days (d) of topical intervention of honey: (e)–(h) demonstrated E-cadherin expression in different cellular layers of epithelium in normal (e) skin and in peripheral biopsies of before (f) and after said days of interventions (g), (h); (i)–(p) depicted expression of Collagen I (i)–(l) and Collagen III (m)–(p) in normal skin (i), (m), preintervention (j), (n) and in early (k), (o) and late (l), (p) periods of postintervention. The expression of p63 (b), E-cadherin (f), collagen I (j) and III (n) in flattened epithelium in preintervention stage and their changed expression status in normal and postintervention periods-p63+ nuclei distribution (a), (c), and (d), increased E-cadherin expression (e), (g), and (h), altered Collagen I (i), (k), and (l) and Collagen III (m), (o), and (p) density, orientation, and distribution.